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Task force recommendations about managing meds in post-acute and long-term care during COVID-19. https://www.pharmacy.umaryland.edu/centers/lamy/optimizing-medication-management-during-covid19-pandemic/
Summary of recommendations in thread below:
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Summary of recommendations in thread below:
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Discontinue or reduce meds that are
- Unnecessary or ineffective (e.g., vitamins, herbals, docusate), or
- Inconsistent with goals of care or limited life expectancy (e.g., statins), or
- Safe to TEMPORARILY d/c even if indicated long-term (e.g., bisphosphonates, calcium)
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- Unnecessary or ineffective (e.g., vitamins, herbals, docusate), or
- Inconsistent with goals of care or limited life expectancy (e.g., statins), or
- Safe to TEMPORARILY d/c even if indicated long-term (e.g., bisphosphonates, calcium)
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Reduce frequency of medication-associated monitoring
- When such monitoring goes beyond clinical need (e.g., BP checks prior to administering routine BP meds)
- If appropriate, d/c meds that need frequent monitoring (e.g., short-acting insulins)
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- When such monitoring goes beyond clinical need (e.g., BP checks prior to administering routine BP meds)
- If appropriate, d/c meds that need frequent monitoring (e.g., short-acting insulins)
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Reduce dosing frequency
- Change from short- to longer-acting meds (e.g., carvedilol CR)
- Change analgesic regimens to reduce dose frequency, if possible
- Switch from short- to longer-acting insulins; change PPIs from BID to QD or d/c entirely
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- Change from short- to longer-acting meds (e.g., carvedilol CR)
- Change analgesic regimens to reduce dose frequency, if possible
- Switch from short- to longer-acting insulins; change PPIs from BID to QD or d/c entirely
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Move statins, alpha blockers, levothyroxine to consolidated dosing times (e.g., AM dosing)
Change meds that require crushing to liquid formulation
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Change meds that require crushing to liquid formulation
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Consolidate dispensing times (e.g., q12 hour to BID) where clinically appropriate, eliminate outlier med dispensing times
Liberalize allowable period for nurses to pass meds
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Liberalize allowable period for nurses to pass meds
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Reduce risks of COVID-19 transmission by
- Use hand-held inhalers instead of nebs, where possible. If switch to MDIs, use spacers.
- Consider change acetaminophen from regular scheduled dosing to as-needed dosing, to aid COVID fever surveillance
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- Use hand-held inhalers instead of nebs, where possible. If switch to MDIs, use spacers.
- Consider change acetaminophen from regular scheduled dosing to as-needed dosing, to aid COVID fever surveillance
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Reduce risks of COVID-19 transmission by
- Where possible, avoid directly touching residents during med passes
- Reduce unnecessarily frequent monitoring related to meds (does not apply to COVID-related monitoring)
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- Where possible, avoid directly touching residents during med passes
- Reduce unnecessarily frequent monitoring related to meds (does not apply to COVID-related monitoring)
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Goal of these recommendations is to reduce unnecessary, harmful, and burdensome med use, & streamline safe medication administration to reduce opportunities for COVID-19 transmission between staff & residents. Efficiencies also allow nurses to focus on other impt tasks.
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Recommendations should be adapted for local situation and individual resident circumstances! But, useful to have a systematic approach to these challenging issues.
Check out the guide at https://www.pharmacy.umaryland.edu/centers/lamy/optimizing-medication-management-during-covid19-pandemic/
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Check out the guide at https://www.pharmacy.umaryland.edu/centers/lamy/optimizing-medication-management-during-covid19-pandemic/
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